Fibromyalgia: An Environmental Scan
Table of Contents
5.3 Areas for Future Research
Previously, research in the area of chronic pain and specifically fibromyalgia has focused on how particular disorders affect the individual such as the impact of symptoms e.g., pain along with other consequences like depression. A vast majority of research in the past has investigated pharmacological agents such as anti-depressants and anti-convulsants for symptom relief. More recently, research has concentrated in the area of neuroscience and a number of studies have focused on the non-invasive imaging options (i.e., CT, MRI’s and PET as examples) with the hope of identifying pathologies and improving diagnostic availability.
Research is in a relatively infant stage concerning fibromyalgia and there are a number of newer and emerging areas. More work needs to be done in the area of genetic research and although no one gene has been isolated for a number of chronic pain syndromes, there is a growing understanding of the importance of investigating the role of genetics in chronic pain disorders. Continued research into gene isolation and the impact one’s genetic make-up has upon the development or maintenance of chronic pain is necessary. As discussed previously concerning CFS, a focus on the impact of viruses on human health and their propensity to cause chronic disease is an emerging area of study specific to chronic pain syndromes such as CFS, fibromyalgia and SLE. Furthermore, once there is a better understanding of the nature and influence of viruses, pharmacological agents can be developed in the hope of creating primary prevention measures in order to avoid developing certain chronic pain disorders from infection. Continued research into the area of neuroscience is very promising. We are beginning to better understand the role of neurotransmitters and neurohormones in chronic pain. Research must continue to examine the impact of over-production, inhibitory effects, neuronal pathways and the effect upon the modifications of such on genetic expression.
As the knowledge base grows regarding the causal agents of chronic pain, equally important work must surround diagnostic tools. In previous sections, the report has highlighted issues surrounding the ACR Classification, the potential to have both misdiagnosed and undiagnosed cases of fibromyalgia and chronic fatigue syndrome, such issues will be addressed through both a better understanding of the etiology and pathology associated with a chronic pain disorder and the development of specific and sensitive diagnostic tools to clearly identify the disorder in a particular individual. In conjunction, prospective epidemiological studies will then capture better estimates of the true prevalence of fibromyalgia and other chronic pain syndromes in the population.
Beyond the pharmacological and physiological areas of research other areas are also important. Given the biopsychological method to understanding disease involves an approach where biological, psychological and social factors all significantly impact disease, research into the effects of psychological and social factors on the development and maintenance of chronic pain disorders is vitally important. Understanding the connection between sociodemographic characteristics such as socioeconomic status will help identify individuals at higher risk of either developing chronic pain disorders or once a traumatic event has taken place, better understanding of the impact of the psychological and social factors will aid in early targeted interventions and care plans designed to shorten both the duration and severity of chronic pain. Particularly, fibromyalgia does not have a gold standard treatment nor evidenced based clinical guidelines, the efficacy of complementary and alternative therapies needs more work to better understand the empirical benefit of self-management techniques and the efficacy of alternative and complementary therapies.